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In the 16 and 17 page of thie document there is a interesting study, because oc my english i dont understand as well as i would like, could someone do a easier conclusions?




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Anonymous's picture
Replies 2
Last reply 7/30/2014 - 12:03pm
Replies by: Anonymous, arthurjedi007

Hello -

Im currently a care taker (along with a few others). My "patient" was diagnosed stage IV in January of this year. Primary was a mole on his side, but the initial diagnosis came from the removal of a tumor on his side. Pet scan showed melanoma had spread to liver, spleen, pelvis, abdomen, spine, right arm & lungs. Before the test results came back for the BRAF mutation he did one round of Ipi. Before his second round they switched treatment and put him on the the MEK combo. In the end of April his LDH started coming down and tumors show stabilization and some decrease. Things stayed like this till end of June. His LDH started rising again and although the origin tumors still remained same and some decreasing two new  tumors came up in his soft tissue. He started back on the Ipi three weeks later. He's now had two rounds and of Ipi and radiation on his arm and pelvis to help levitate some pain he's in. Recently he's started having spasms and twitching. I don't know whether to attribute it to the disease that may have moved to the brain or all the medication he's taking? The other think I wonder is if the Mek combo caused the stabilization or if it was the initial round of Ipi that kicked in. My fear is that he won't make it long enough to see if the Ipi works.

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Nell's picture
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Has anybody had loose green stools during treatment with yervoy?

One voice can make a song; one life can change the world.

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Anonymous's picture
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You would think being outside on the skin that skin cancer would lend itself even more to this. . . .



Chicago Tribune

Angela Zimm, Bloomberg News,
30 July 2014,
1260 words,
Copyright 2014, Chicago Tribune. All Rights Reserved.

Which is better at detecting cancer, a laboratory or a Labrador retriever?

Consider the talents of Tsunami, a dog with attentive eyes and an enthusiastic tail wag for her trainer friends. University of Pennsylvania researchers say she is more than 90 percent successful in identifying the scent of ovarian cancer in tissue samples, opening a new window on a disease with no effective test for early detection that kills 14,000 Americans a year. When found early, there's a five-year survival rate of over 90 percent.

With 220 million olfactory cells in a canine nose, compared with 50 million for humans, dogs have long helped in search-and-rescue missions. Now, a growing body of evidence supports the possible use of canines by clinicians. The largest study ever done on cancer-sniffing dogs found they can detect prostate cancer by smelling urine samples with 98 percent accuracy. At least one application is in the works seeking U.S. approval of a kit using breath samples to find breast cancer.

"Our study demonstrates the use of dogs might represent, in the future, a real clinical opportunity if used together with common diagnostic tools," said Gian Luigi Taverna, the author of the prostate cancer research reported in May at the American Urological Association in Boston.

While smaller studies have long shown dogs can sniff out a range of illnesses, the question of whether they can be used on a large-scale basis has drawn skepticism. Questions remain about whether one type of dog is better than another, how to systemize their use and the financial viability of any such system. As a result, most current research is looking at how to copy the canine ability to smell disease either with a machine or a chemical test.

"Our standardized method is reproducible, low cost and noninvasive for the patients and for the dogs," said Taverna, the head of urology pathology at Istituto Clinico Humanitas in Rozzano, Italy, in an email.

Taverna tested the ability of two professionally trained explosive detection dogs, Zoe and Liu, in 677 cases to assess their accuracy, according to his paper. The next step, according to Taverna, will be to extend the research into prostate cancer subgroups and to other urological malignancies.

The results may one day be used to help develop an electronic nose that follows nature's lead in how a canine nose works, he said.

Taverna's finding comes as standard PSA testing for prostate cancer is challenged as not accurate enough, with false positives leading to unnecessary treatment.

In 2012, the Preventive Services Task Force, which reports on medical issues to the U.S. Congress, recommended that healthy men shouldn't be screened for prostate cancer using PSA tests after research showed that false positive rates may be as high as 80 percent. The test measures a protein made by prostate cells called prostate-specific antigen.

When dogs sniff for cancer, they are detecting the chemicals emitted by a tumor. These chemicals are referred to as volatile organic compounds, or VOCs. VOCs have been found in the breath of lung cancer patients and colon cancer patients, as well as in the urine of prostate cancer patients. The most recent findings have spurred increased interest in dog cancer-detection research, including efforts to develop devices that can mimic the animal's olfactory system.

Dina Zaphiris, a nationally recognized dog trainer who works with canines on federally funded studies in detecting early cancer in humans, is leading the charge for Food and Drug Administration clearance of a system that would use the olfactory talents of dogs in medical care.

In 2009, Zaphiris, a dog trainer for 25 years with an extensive list of celebrity clients and an education in biology, founded the In Situ Foundation, a nonprofit organization that trains cancer-sniffing dogs and conducts research in the field.

Her organization is submitting an FDA application for approval of a canine medical scent detection kit. In her system, patients exhale through a tube on to a cloth, which captures molecules, or VOCs, of a malignancy. Trained dogs would then sniff the cloths for their presence. The dog screening would be an "early warning test," she said, possibly used in connection with a mammogram for reviewing results before proceeding to a biopsy.

"You should see the amount of emails I get saying, 'I got an unclear mammogram, and I don't know if I want a biopsy, so could I have dogs screen my breath sample?' " Zaphiris said.

Zaphiris' interest in the issue began in 2003 when she worked on a study to detect breast and lung cancer. A paper on that limited study, published in 2006 in the Journal of Integrative Cancer Therapies, found that dogs could detect lung tumors with 99 percent sensitivity and 99 percent specificity; for breast tumors, results were 88 percent sensitivity and 98 percent specificity.

Now Zaphiris is working with Jeffrey Marks, an associate professor of surgery and pathology at Duke University to train dogs to detect breast cancer, she said. It takes about six weeks to teach a dog, and Zaphiris says she usually trains a new team of canines for each one, working at her 3-acre facility in West Hills, Calif.

Zaphiris isn't alone in her quest to get dogs involved in medical care. At the University of Pennsylvania School of Veterinary Medicine, researchers are studying whether dogs can find ovarian cancer in tissue and blood samples. If so, it would be a breakthrough for a difficult disease.

"We're trying a multiprong approach," including the dogs and laboratory efforts, "to determine if there's some signature in blood in women with ovarian cancer so we can develop a detection system," said Cindy Otto, director of the university's Penn Vet Working Dog Center in Philadelphia.

The project, which began last year, is now focused on training the dogs using tissue samples from both cancerous ovaries and ovaries with benign disease.

Tsunami, the German shepherd named for her tendency to come happily at you when you least expect it, has been particularly successful early in her training, Otto said. When she's working, she becomes quiet and pensive. She works slowly, circling a wheel containing blocks of samples. She sniffs, she stops, she thinks, Otto said. When she identifies cancer, she sits; that's the sign.

The research effort is a collaboration among chemists, doctors and physicists at the university, with a primary focus on developing an "electronic nose" that duplicates a dog's ability to smell disease. Otto said she doesn't think using dogs in a clinical setting would be practical.

"The challenge is the expense," she said. "If you're talking about screening every woman from 25 to 90, that's a lot of samples."

Zaphiris said the medical system shouldn't wait for the development of technology that can accurately sense cancer with the ability of a dog. Her goal is to open canine scent detection centers that will make her animals accessible beyond just their use for research.

"If there is a machine as accurate as a dog, I say do it," Zaphiris said. "It's highly impractical to wait until the machines can catch up."


Chicago Tribune


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Sherri's picture
Replies 1
Last reply 7/30/2014 - 1:10pm
Replies by: Janner

Hi this is my first time posting.  I'm especially interested in Janners response:). I've read a lot of your replies.  I had a .3 mm depth stage 1A in November.  In June of this year I was told I had an in situ on my back but I go to U Of M for surgeries and my derm sends the oaths to them....they changed that ex to moderately atypical hyperplasia.  We still did the surgery as if it were in situ.  I know I shouldn't worry about recurrence?  But what are my chances of a second primary with dysplastic nevus syndrome?  I've had so many answers from we don't put a number on it to 20% from a good derm who said whether a person has one dysplastic mole or 50 their chances are 20% for a second primary.  I have two boys so young and this consumes me where I'm going to counseling.  I know someone who sees an oncologist and a derm for a stage 1 and yhe oncologist just does a second body scan and checks nodes and blood.... Thoughts?  This is so new to me that I need info!  I sure am afraid of this:(. 



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curious12's picture
Replies 2
Last reply 7/30/2014 - 11:03am
Replies by: curious12, Anonymous

Hi! I've had melanoma in-situ and my sibling has. We have tons of moles and I've probably had 50+ removed. I'm pretty knowledgeable on all things melanoma. My 8 year old son has a a new small, red/flesh colored bump on his forehead. It's very harmless looking (doesn't itch or hurt) but it isn't going away. It has only been maybe 12-14 days. I know melanoma in kids can present this way. I WILL get it biopsied if it doesn't go away of course, but what timeframe do you think is reasonable to wait? I was thinking 2 more weeks and then get it cut out, but is that crazy? I don't want to let my anxiety take over and cut into his face too soon! Don'T care about scars, but realize there are a million benign things that are more likely. Saw a derm today-- she wasn't sure. Said looks harmless- - maybe cyst or insect bite. There is no head to it. She said to come back in 4-6 weeks if still there.. but I don't even want to wait that long!!   He also has a very dark brand new dark spot on sole of foot that two derms say looks fine, but I don't like it (it's 1mm) It's almost black and on the sole of foot.. considering biopsy as well.. Would love to know if I'm being reasonable or overboard. thanks!

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BrianP's picture
Replies 10
Last reply 7/30/2014 - 11:35am

Your comments on the NED thread really hit a chord with me.  I've been thinking of that very topic quite a bit lately.  G-Samsa, like you I am in a Ipi-Nivo trial and like you I've had a about a 50 to 60% percent reduction in tumors initially and now seem to have reached a stable status.  I did not realize what a common response this was with the anti-pd1 drugs until watching the immunotherapy presentation I posted several days ago on  G-Samsa, I think it may have been the study you are participating in which they posted the graph of responses.  If I remember correctly the graph I saw only showed one complete responder and the rest of the responders acheived a stable result at around 30 weeks that seemed to be pretty durable.  Joe you summed it up much better than I can about all the implications surrounding living with this disease.  G-Samsa, I read your comments from your doctor with great interest concerning his/her belief that our immune system should now be able to do the job on it's own.  My doctor and I have just briefly talked about the subject.  He made an interesting comment about options down the road so "I don't have to be on nivo the rest of my life."  I believe he's thinking about options like SBRT for two small tumors I have remaining.  It will be real interesting to see where the medical community falls out on this subject. 

I really don't like the idea of living with stable disease but I know there are many on here that would do anything to be in my situation right now so I know it's a true blessing.  Many of you probably read T.J. Sharpe's blog.  He made a great comment the other day on his blog: "stable is a tie, a tie is a win, even if it's not the result we desire." 



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Tracy Chicago's picture
Replies 4
Last reply 7/30/2014 - 10:47am
Replies by: Tracy Chicago, CHD, 5dives

Has anyone sucessfully insisted on lymphatic mapping for a Level 1 melanoma? I ask because my first primary was level 1 and then three years it spread to my lymph nodes, making me stage 3.  I now have a second level 1 melanoma in a different place. I'd like to request lymphatic mapping considering my history.

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Replies by: Bubbles, Anonymous, maryb-z, Gene_S

Dear MPIP Community,

If you haven't already heard, the Surgeon General has issued a Call to Action to Prevent Skin Cancer. Please take a look at the MRF's press release to learn more about the Call to Action and what it means. The MRF commends the Surgeon General for issuing this statement and taking a great step toward identifiying important steps that will help reduce the rates of melanoma diagnoses. 


Shelby - MRF

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dodgedh2's picture
Replies 19
Last reply 7/29/2014 - 9:03pm

I was originally diagnosed at Stage 4 (met to bone) w/unknown primary. Following resection and gamma radiation treatment at surgery, I have been NED for just over 6 years now. My Onc released me from oncology and turned me over to PC for monitoring. No scans (unless I have symptoms or some other reason to suspect return). I'd like to hear from other long-term, late stage NED survivors. Has anyone experienced long-term NED then had recurrence? How long were you NED? Just going through one of those periodic anxiety moments about having survived Stage 4 and looking over my shoulder again.

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gaby's picture
Replies 14
Last reply 7/29/2014 - 8:22am


My husband is stage 3A since July 2012. He is with interferon pegylado treatment since October 2012. Since his diagnosis that we have no holiday. My husband is terrified of being under the sun, so is very difficult to go out somewhere. I do not know how to solve this issue. My husband used sunscreen but the sunscreen does not give the peace. He is now 40 years old.

Appreciate any advice



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jualonso's picture
Replies 2
Last reply 7/29/2014 - 9:18am
Replies by: Ginger8888, jack6020

Hi folks,

No one of us would like to be part of a big trial like this, but unfortunately we are.

Im thinking to collect some datas of each of us (just stage iv) that i think, crossing them we will be able to get some answers about why some treatments work o not. May nothing can be gotten but who knows, we are a lot of people and perhaps with a lot of data is possible to realize of something. This is just and idea. what to do you think about it?

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ymellin's picture
Replies 2
Last reply 7/26/2014 - 6:10pm
Replies by: ymellin, Janner

Hi, I just had surgery this past week for melanoma in situ. The area was the front of my right shoulder and I have a 3 inch incision. Am waiting for biospy reports to return to make sure that all is clear. Can anyone tell me what happens after this? 

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tcell's picture
Replies 5
Last reply 7/27/2014 - 4:43am

Hi all,

- diagnosed with stage IV in Februrary with lots of tumors in lungs, chest, abdomen, liver, bones

- good initial response to Taf / Mek, last scans in May showed considerable shrinkage everywhere

- bloodwork in June already not 100% ok so put staging one month earlier to July 21

- results show considerable growth in chest, lunhs, one liver met shrinking, one growing....bones stable. I got chest pain and cough and I am scared to death which I guess is kind of normal.

Guess that's it for the combo. Discussed with my specialist. Next step will be Ipi and continuation of Taf with just short breaks before and after the infusions. He said that there are good results from an Australian Phase 1 trial with that Combo. He hopes that Taf will put kind of a brake on tumor growth as my burden is rather high until Ipi kicks in  He says it is important to discontinue Mek as this caused severe troubles in combination with Ipi.

next option if something goes wrong will be Anti-Pd1 EAP. I hope, however, not to fail Ipi.

any comments, suggestions and uplifting words are welcome!

Thanks to all of you who are of such great help in dealing with this illness.


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Replies by: fortiz, tcell, jualonso, Anonymous

Hi folks,

Finally i have decided to stop with combo, i was talking with my doc about to start

Mek anti pd1, but the condition is to progress on ipi or braf inhibitors, then the only option i have is to stop taking pills before the next PetScan and show progression in it (now in NED)

Is a very tought decision but i dont have any other option if i want to avoid resistance and still keep these drugs with pottencial for the future.

I would be very gratefull any help from someone who has follow the same path




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